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FIGO good practice recommendations on the use of pessary for reducing the frequency and improving outcomes of preterm birth

Research output: Contribution to journalArticlepeer-review

the FIGO Working Group for Preterm Birth

Original languageEnglish
Pages (from-to)23-25
Number of pages3
JournalInternational Journal of Gynecology and Obstetrics
Volume155
Issue number1
DOIs
PublishedOct 2021

Bibliographical note

Funding Information: William A. Grobman reports no conflicts of interest. Jane Norman reports receipt of grants from government and charitable bodies for research into understanding the mechanism of term and preterm labour and understanding treatments; participation in a Data Safety and Monitoring Board for a study involving a preterm birth therapeutic agent for GlaxoSmithKline; and consultancy for Dilafor on drugs to alter labour progress. Bo Jacobbson reports research grants from Swedish Research Council, Norwegian Research Council, March of Dimes, Burroughs Wellcome Fund and the US National Institute of Health; clinical diagnostic trials on NIPT with Ariosa (completed), Natera (ongoing), Vanadis (completed) and Hologic (ongoing) with expendidures reimbused per patient; clinical probiotic studies with product provided by FukoPharma (ongoing, no funding) and BioGaia (ongoing; also provided a research grant for the specific study); collaboration in IMPACT study where Roche, Perkin Elmer and Thermo Fisher provided reagents to PLGF analyses; coordination of scientific conferences and meetings with commercial partners as such as NNFM 2015, ESPBC 2016 and a Nordic educational meeting about NIPT and preeclampsia screening. Bo Jacobbson is also Chair of the FIGO Working Group for Preterm Birth and the European Association of Perinatal Medicine's special interest group of preterm delivery; steering group member of Genomic Medicine Sweden; chairs the Genomic Medicine Sweden complex diseases group; and is Swedish representative in the Nordic Society of Precision Medicine. Funding Information: This work has been supported by grants from March of Dimes. Publisher Copyright: © 2021 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

A pessary is a device made of synthetic material that is placed in the vagina and has been used for prevention of preterm birth. It has been suggested that a potential mechanism of the pessary is alteration of the cervico-uterine angle to a more posterior position, which reduces cervical compression in women with a singleton pregnancy and a short cervical length. Pessaries should not be used in routine clinical care to reduce the frequency of preterm birth or to improve outcomes (e.g. neonatal outcomes) related to preterm birth. In women with a twin pregnancy—regardless of cervical length—pessaries should not be used in routine clinical care to reduce the frequency of preterm birth or to improve outcomes (e.g. neonatal outcomes) related to preterm birth. Presently there is no sufficient evidence suggesting that pessaries should be used as a standard treatment to prevent preterm birth; their use should be reserved for study populations.

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